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An in vitro biomechanical comparison of anterior cruciate ligament reconstruction: single bundle versus anatomical double bundle techniques.

Sasaki SU, Mota e Albuquerque RF, Pereira CA, Gouveia GS, Vilela JC, Alcarás Fde L - Clinics (Sao Paulo) (2008)

Bottom Line: One of these variations is the anatomical double bundle technique, which is performed instead of the conventional single bundle technique.Maximum anterior dislocation, rigidity, and passive internal tibia rotation were recorded with knees submitted to a 100 N horizontal anterior dislocation force applied to the tibia with the knees at 30, 60 and 90 degrees of flexion.There were no differences between the two techniques for any of the measurements by ANOVA tests.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. sandraort@uol.com.br

ABSTRACT

Introduction: Anterior cruciate ligament ruptures are frequent, especially in sports. Surgical reconstruction with autologous grafts is widely employed in the international literature. Controversies remain with respect to technique variations as continuous research for improvement takes place. One of these variations is the anatomical double bundle technique, which is performed instead of the conventional single bundle technique. More recently, there has been a tendency towards positioning the two bundles through double bone tunnels in the femur and tibia (anatomical reconstruction).

Objectives: To compare, through biomechanical tests, the practice of anatomical double bundle anterior cruciate ligament reconstruction with a patellar graft to conventional single bundle reconstruction with the same amount of patellar graft in a paired experimental cadaver study.

Methods: Nine pairs of male cadaver knees ranging in age from 44 to 63 years were randomized into two groups: group A (single bundle) and group B (anatomical reconstruction). Each knee was biomechanically tested under three conditions: intact anterior cruciate ligament, reconstructed anterior cruciate ligament, and injured anterior cruciate ligament. Maximum anterior dislocation, rigidity, and passive internal tibia rotation were recorded with knees submitted to a 100 N horizontal anterior dislocation force applied to the tibia with the knees at 30, 60 and 90 degrees of flexion.

Results: There were no differences between the two techniques for any of the measurements by ANOVA tests.

Conclusion: The technique of anatomical double bundle reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone graft has a similar biomechanical behavior with regard to anterior tibial dislocation, rigidity, and passive internal tibial rotation.

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Related in: MedlinePlus

Displacement versus three cycles of load curve.
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f4-cln63_1p0071: Displacement versus three cycles of load curve.

Mentions: The “zero test point” was determined by a previous short cycle with a posterior drawer followed by an anterior drawer under 50 N load (Figure 3), and the inflexion point of this curve was registered as the “zero point.” All biomechanical tests in the protocol were begun with a short posterior drawer to ensure the presence of the predetermined “zero point” on the anterior drawer curves of the three cycles (Figure 4). The specimens were not disconnected from the original steel tube fixation at any time, including during surgeries, when the whole system was disconnected from the Kratos Machine grips.


An in vitro biomechanical comparison of anterior cruciate ligament reconstruction: single bundle versus anatomical double bundle techniques.

Sasaki SU, Mota e Albuquerque RF, Pereira CA, Gouveia GS, Vilela JC, Alcarás Fde L - Clinics (Sao Paulo) (2008)

Displacement versus three cycles of load curve.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664185&req=5

f4-cln63_1p0071: Displacement versus three cycles of load curve.
Mentions: The “zero test point” was determined by a previous short cycle with a posterior drawer followed by an anterior drawer under 50 N load (Figure 3), and the inflexion point of this curve was registered as the “zero point.” All biomechanical tests in the protocol were begun with a short posterior drawer to ensure the presence of the predetermined “zero point” on the anterior drawer curves of the three cycles (Figure 4). The specimens were not disconnected from the original steel tube fixation at any time, including during surgeries, when the whole system was disconnected from the Kratos Machine grips.

Bottom Line: One of these variations is the anatomical double bundle technique, which is performed instead of the conventional single bundle technique.Maximum anterior dislocation, rigidity, and passive internal tibia rotation were recorded with knees submitted to a 100 N horizontal anterior dislocation force applied to the tibia with the knees at 30, 60 and 90 degrees of flexion.There were no differences between the two techniques for any of the measurements by ANOVA tests.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. sandraort@uol.com.br

ABSTRACT

Introduction: Anterior cruciate ligament ruptures are frequent, especially in sports. Surgical reconstruction with autologous grafts is widely employed in the international literature. Controversies remain with respect to technique variations as continuous research for improvement takes place. One of these variations is the anatomical double bundle technique, which is performed instead of the conventional single bundle technique. More recently, there has been a tendency towards positioning the two bundles through double bone tunnels in the femur and tibia (anatomical reconstruction).

Objectives: To compare, through biomechanical tests, the practice of anatomical double bundle anterior cruciate ligament reconstruction with a patellar graft to conventional single bundle reconstruction with the same amount of patellar graft in a paired experimental cadaver study.

Methods: Nine pairs of male cadaver knees ranging in age from 44 to 63 years were randomized into two groups: group A (single bundle) and group B (anatomical reconstruction). Each knee was biomechanically tested under three conditions: intact anterior cruciate ligament, reconstructed anterior cruciate ligament, and injured anterior cruciate ligament. Maximum anterior dislocation, rigidity, and passive internal tibia rotation were recorded with knees submitted to a 100 N horizontal anterior dislocation force applied to the tibia with the knees at 30, 60 and 90 degrees of flexion.

Results: There were no differences between the two techniques for any of the measurements by ANOVA tests.

Conclusion: The technique of anatomical double bundle reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone graft has a similar biomechanical behavior with regard to anterior tibial dislocation, rigidity, and passive internal tibial rotation.

Show MeSH
Related in: MedlinePlus